Medicare is the nation’s largest health insurance program. It covers over 40 million people and makes payments of about $500 billion per yea, of which, almost $48 billion is estimated to be improper.

Improper payments can be due to fraud, waste or abuse. These numbers are staggering.

Examples of health-care fraud include the following:

Billing for services or equipment not providedBilling for unnecessary services or equipment;

Upcoding or unbundling services;

Counterfeit prescription drugs;

Inferior or used equipment sold as new and kickbacks.

Clearly, there are a number of fraudulent schemes. Here are a few things you can do to protect yourself:

1) Keep a record of your medical activities by date, service received, equipment provided, tests run, etc.

2) Ask questions. If uncomfortable asking, have an advocate, such as a family member, help you.

3) Review your Medicare Summary Notice or Explanation of Benefits. Do they match your records?

4) Examine the medication you receive. Look at the container for misspellings, fading colors, or ill-fitting packaging. Look at the pills. They should be the same color, shape and have the same markings.

5) If told that Medicare normally does not cover something, be wary if the provider says that they have a work-around.

6) Never accept payments for your information or agree to participate in a fraud.

7) Never give out your Medicare ID number or other personal information to anyone making door-to-door sales or solicitation over the phone unless you initiated the contact.

If you suspect fraud, contact Medicare at 1-800-MEDICARE (1-800-633-4227) or the Washington State Office of the Insurance Commissioner at 1-800-562-6900. For information, visit www.medicare.gov or www.insurance.wa.gov/shiba.

Steve Geertz, CPA, CFE is principal of BG & Company LLC in Kirkland. Contact Steve at 425-891-8752 or steve.geertz@bgco-llc.com.